The Controversy and The Reality about Recovery from Borderline Personality Disorder

There is controversy about recovery from Borderline Personality Disorder (BPD). This controversy stems from the complicated nature of BPD, the focus on the criteria for diagnosis, focus on medication and the notion that BPD is "all biological" and the neglect or failure on the part of professionals in terms of actually mapping out what the process of recovery from BPD is and what recovery from BPD can be defined as – how it can be measured.

As far as I know there has not, as of yet, anyway, been any professional who has actually come out and said here’s what you need to do to recover from BPD – or here is what recovery looks like. Some believe that merely not having 5 out of the 9 traits listed in the DSM-IV means one is no longer borderline. I don't think recovery is that simple. I think there are stages to recovery. In the process of recovery, eliminating the number of traits that define BPD means that one is getting better, one is actively in recovery. There is also the idea out there that if you were suicidal and you aren't anymore, or if you self harmed and you don't anymore that equals recovery. Again, I would say, based on my own experience that these are stages of getting better on the road to recovery.

To date professionals seem content with the focus that is placed mainly in the following three areas:

What’s wrong with this?

To begin with focusing only on the criteria for diagnosis defines the problem without offering the hope for its solution. The focus on medication now available or medication that many (not all) professionals like to claim will “someday” be the “cure-all” for BPD to treat symptoms as they present or manifest themselves does little, if anything, really, toward addressing what really needs to be addressed jointly by professionals and by those who have BPD in order for recovery to be possible.

One of the main controversial areas of Borderline Personality Disorder that fails to offer any hope for recovery is the continued focus (again by some – not all professionals) who continue to maintain (with insufficient evidence, in my opinion) that BPD is this ”all biological reality” that will take the discovery of some "wonder-drug" to fix or forever manage.

What Else Leaves Those With BPD Lacking Hope That Recovery Is Possible?

The on-going debates about what causes BPD, in many ways, are more harmful to those looking for help and to recover in the here and now. If the focus is placed upon causation or waiting to figure out what causes BPD in some irrefutable way the consequence of that is the continued suffering of those who have been diagnosed with BPD and who need effective treatment for it now. Treatment that doesn’t begin with the premise that one can’t get better. Treatment that isn’t a revolving door of punitive and unsupportive stigmatized judgment on the part of (again not all) many mental health professionals.

Are There Systemic Obstacles To Recovery?

YES!

Along with the reality for many with BPD that there are personal obstacles and the obstacles to recovery that are inherent in the very nature of what it means to have BPD, there are systemic obstacles as well.

I will go one controversial step further here and say that, from my own experience, there is perhaps a surprisingly high number (again certainly not all) mental health professionals who are on the front lines of the delivery of mental health services, who themselves have BPD. This throws a monkey-wrench of mammoth proportions into the mix. Those professionals who have BPD (whether they have been diagnosed or not) by the very nature of their own issues can spell disaster for the borderlines that might enter their offices seeking help and unbiased professional treatment.

There are many systemic reasons for the stigmatization of Borderline Personality Disorder. A stigmatization that marginalizes even the best efforts of those dedicated to getting well. There are many obstacles and challenges presented by these stereotyped stigmas that make it more difficult for many with BPD to find the kind of treatment that is required in order to get on and stay on the road to recovery.

Another systemic obstacle to recovery is the intractable and polarized idea on the part of (some not all) mental health professionals that BPD is intractable and that those diagnosed with can’t recover. This notion along with the increasing constraints on mental health care delivery systems due to funding issues means that those diagnosed with BPD are seen as taking up too much of the resources without the kind of return on those resources that studies deem acceptable.

This means that programs that can be very highly effective for many with BPD rather than increasing to meet the demand of an increasing population of those diagnosed with BPD are actually decreasing. These programs are casualties of a lack of funding. When mental health care programs are casualties of decreasing funding, borderlines become casualties of decreasing odds as to the possibility of recovery in many cases.

The Polarized Intractable Belief That Borderlines Can’t Recover

Some borderlines themselves in their own polarized and exceedingly negative experience and negative outlook based upon what it is that they continue to feel (which is often what is actually thought about in what are cognitively distorted thoughts) get to such a place of helplessness interwoven with hopelessness that they do not believe that they can ever get better, let alone recover.

It is important for those with BPD, new to the diagnosis, new to facing the reality and scope of the diagnosis, even if diagnosed years ago, or who are stuck still for whatever reason or reasons, to open up the possibility of change, growth, and getting better. One must believe in this possibility in order to find his or her way to the actualizing of it.

If a professional, a therapist, believes that borderlines can’t recover, frankly, I don’t know what they are doing in the profession that they are in. The possibility and potential for recovery must begin with the belief in its possibility. Without that – it isn’t possible. This believe or at the very least the potential to consider the possibility of recovery must be held and shared by both the therapist and the borderline if there is to be any chance for recovery.